Diabetes Health

Diabetes and Depression Linked, Study Shows

The relationship between diabetes and depression apparently cuts both ways: Not only are people with treated type 2 diabetes at a greater risk for developing depression, individuals with depression are also at risk for developing diabetes.

Type 2 diabetes and clinical depression tend to go hand in hand, the study authors say, although the question has been, which comes first? The study was published in the Journal of the American Medical Association.

"There have been studies that show people with diabetes are twice as likely to have symptoms of depression as those who don't, and it could either be because depression itself leads to the development of type 2 diabetes or it could be that having diabetes leads to the development of depression," says study lead author Dr. Sherita Hill Golden, at Johns Hopkins University School of Medicine.

"There are several studies showing that depression and depressive symptoms lead to the development of type 2 diabetes, but only a couple of studies showing that diabetes itself leads to depression. We wanted to look to see whether or not we could tease out the chicken-and-egg situation," she says.

More Depressed, the Greater the Risk

Previous studies have also found that treating depression can help extend the lives of people with diabetes.

The authors of the new study performed two analyses, both using information from participants in the Multi-Ethnic Study of Atherosclerosis trial.

The first analysis involved 5,201 individuals without type 2 diabetes at the start of the clinical trial. These participants had symptoms of depression. It found that greater depressive symptoms were linked with a 42 percent greater chance of developing diabetes during the follow-up period.

The study found that the stronger the depressive symptoms, the higher the chance of developing diabetes.

After looking at factors such as overweight, not exercising, and smoking, the risk of developing diabetes was still 34 percent higher in patients with depression.and found that treated type 2 diabetes was associated with a 54 percent increased risk of developing depressive symptoms over 3.2 years.

"Those with depression are more likely to consume more calories, be less physically active, and are more likely to smoke, so they just have poor overall health behaviors in general," notes Dr. Golden. "That seems to be one component of treating depression that needs to be addressed."

The second analysis included 4,847 people without depressive symptoms. Those with treated type 2 diabetes had a 54 percent increased risk of developing depressive symptoms over three years.

People with untreated diabetes were not at risk of developing depression.

People with pre-diabetes or untreated diabetes were 25 percent less likely to develop depressive symptoms than people with normal fasting blood sugar levels.

"That was a little bit of a surprise," says Dr. Golden. The study authors are not sure why this was so, but suggest that maybe the monitoring associated with treating diabetes might contribute to depression.

Talk with Your Physician, Coordinate Care

The findings indicate that integration of care may be helpful to these patients, says Dr. Golden.

"For people who are being treated for symptoms of depression, it's important also to think about some treatment modalities that can also help them adopt healthy behaviors," she says. "And certainly among people who have treated diabetes and who are at risk of developing depression, we need to be aware of that increased risk."

The research revelation suggests that both physicians and patients need to be more aware of the dual risks.

"Doctors should have their sensitivity increased toward picking up on the potential for more of their diabetes patients and more of their depression patients having susceptibility to the other disorder," says Dr. Stuart Weiss, at New York University.

Dr. Golden serves on the Merck & Co.'s clinical diabetes advisory board. The study was supported by the National Institutes of Health (NIH).

September 2008

Understanding Depression

Knowing when to seek treatment for mental health disorders is important for parents and families.

Many times, families, spouses, or friends are the first to suspect that their loved one is challenged by feelings, behaviors, and/or environmental conditions that cause them to act disruptive, rebellious, or sad.

This may include, but is not limited to, problems with relationships with friends and/or family members, work, school, sleeping, eating, substance abuse, emotional expression, development, coping, attentiveness, and responsiveness.

It is also important to know that persons of different ages will exhibit different symptoms and behaviors. Familiarizing yourself with the common maladaptive behaviors of children, adolescents, and adults will often help to identify any problems early, in their most treatable state.

It is important for families who suspect a problem in one, or more, of these areas to seek treatment as soon as possible. Treatment for mental health disorders is available.

The following are the most common symptoms of a potential emotional, behavioral, and/or developmental problem in an adult, which necessitates a psychiatric evaluation.

Symptoms include:

significant decline in work performance, poor work attendance, and/or lack of productivity